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NPI Profile for DERRIKA L JACKSON in LIVINGSTON, TX.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Professional |
101YP2500X |
| NPI Number | 1376725291 |
|
| Status | Active | |
| Credentials | LPC I | |
| Entity | Individual | |
| Enumeration date | 12/03/2007 | |
| Last updated | 12/03/2007 - About 19 years ago | |
| Sole proprietor 1 | Yes | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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DERRIKA L JACKSON
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DERRIKA L JACKSON, LPC I